Impact of Psychosocial Stress on Time-to-Pregnancy

NICHD正在与牛津大学的Cecilia Pyper博士合作，评估心理社会压力对女性生育力的影响，以怀孕时间为衡量标准。 具体来说，NICHD将在Pypers博士目前正在进行的牛津概念研究（OCS）中建立一个压力组件。 OCS是一项三臂随机临床试验，旨在评估数字生育监测器的每日反馈是否会增加希望怀孕的女性的受孕率。 参加OCS的妇女在试图怀孕时被跟踪长达六个月。 在此期间，女性每月向调查人员发送每日日记信息，情绪问卷和生育监测数据。 将比较三组中每一组妇女的三个月和六个月累积妊娠率。 NICHD在牛津受孕研究中增加了一个组成部分，目的是测量压力及其对牛津受孕研究新登记妇女（约400名妇女）生育能力的影响。NICHDs的研究目的是：1）评估感知的心理社会压力对怀孕时间的影响; 2）评估生理压力对怀孕时间的影响; 3）评估感知的心理社会压力是否与生理压力相关;评估是否存在潜在的焦虑和抑郁，社会支持，控制点，或自尊混淆或修改之间的关系感知心理压力或生理压力和怀孕时间。 将分析唾液样本的两种应激生物标志物，即，皮质醇和α淀粉酶。 科恩感知压力量表将用于测量感知的心理社会压力。 其他几种心理社会工具将在基线时进行管理，以使我们能够评估它们是否混淆或改变生理压力或感知的心理社会压力与怀孕时间之间的关系。 已经完成了唾液生物标志物和TTP以及心理社会压力的数据分析。

NICHD is collaborating with Dr. Cecilia Pyper, Oxford University, to assess the impact of psychosocial stress on female fecundity as measured by time-to-pregnancy. Specifically, NICHD will build a stress component into Dr. Pypers currently ongoing Oxford Conception Study (OCS). The OCS is a three-arm randomized clinical trial designed to evaluate whether or not daily feedback from a digital fertility monitor increases the conception rate among women desiring pregnancy. Women enrolled in the OCS are followed for up to six months as they try to conceive. During this time, women send daily diary information, a mood questionnaire and data from their fertility monitor to the investigators on a monthly basis. Three-month and six-month cumulative pregnancy rates will be compared for the women in each of the three groups. NICHD has added a component to the Oxford Conception Study (OCS) with the expressed intent of measuring stress and its impact on female fecundity among newly enrolled women in the OCS (approximately 400 women). The NICHDs research objectives are: 1) to evaluate the effect of perceived psychosocial stress on time to pregnancy; 2) to evaluate the effect of physiologic stress on time to pregnancy; 3) to assess whether or not perceived psychosocial stress is associated with physiologic stress; and 4) to assess whether or not underlying anxiety and depression, social support, locus of control, or self-esteem confound or modify the relation between perceived psychosocial stress or physiologic stress and time-to-pregnancy. Saliva samples will be analyzed for two biomarkers of stress, viz., cortisol and alpha amylase. The Cohens Perceived Stress Scale will be used to measure perceived psychosocial stress. Several other psychosocial instruments will be administered at baseline to allow us to assess whether or not they confound or modify the relation between physiologic stress or perceived psychosocial stress and time-to-pregnancy. Data analysis has been completed for salivary biomarkers and TTP, and for psychosocial stress.